New treatments for addiction. Behavioral, ethical, legal and social questions

This research is advancing on promising new means of treating drug addiction using immunotherapies and sustained-release (depot) medications. The aim of this research is to develop medications that can block or significantly attenuate the psychoactive effects of such drugs as cocaine, nicotine, heroin, phencyclidine, and methamphetamine for weeks or months at a time. The promise of the new medications rests not only on their longer action, but also on differences in the way they operate. Unlike most existing treatments, which are active in the brain itself, immunotherapies act by binding the drug in the bloodstream and preventing it from reaching the brain. This represents a fundamentally new therapeutic approach that shows promise for treating drug addiction problems that were difficult to treat in the past. Despite their potential benefits, however, several characteristics of these new methods pose distinctive behavioral, ethical, legal, and social challenges that require careful scrutiny. At the request of and with support from the National Institute on Drug Abuse (NIDA), the National Research Council and Institute of Medicine established the Committee on Immunotherapies and Sustained-Release Formulations for Treating Drug Addiction to develop recommendations for research in this emerging field. Specifically, the committee was charged with identifying and defining distinctive behavioral, ethical, legal, and social issues that are likely to arise if and when these medications become available for treating drug addiction. Such issues can be considered unique aspects of safety and efficacy that are fundamentally related to the distinct nature and properties of these new types of medications.